Individual provider Active NPI

Chelsea Ludlow, OTR/L

  • Occupational Therapist
  • Soldotna, AK
National Provider Identifier
1770031767
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
PHYO2861 Issued in AK
Practice address
221 W Marydale Ave
Soldotna, AK 99669-7420
Phone
(907) 262-2596
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X PHYO2861 AK Primary

Addresses

Primary practice location

221 W Marydale Ave
Soldotna, AK 99669-7420

Mailing address

PO Box 1650
Kenai, AK 99611-1650
Phone (907) 953-8124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160921002409 AK Practitioner - Occupational Therapist in Private Practice 2668769431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revolution Sport and Spine Therapy LLCGroup PAC ID 6507146412, 19 clinicians

Practice addresses (Care Compare)

35249 Kenai Spur Hwy
Suite C
Soldotna, AK 99669-7673
Phone (907) 420-0836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PHYO2861AKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Revolution Sport & Spine Therapy LLC CurrentSince Mar 18, 2024 Accepting new patients
Borealis Chiropractic Inc CurrentSince Mar 18, 2024 Accepting new patients

Locations

35165 K B Dr
#A
Soldotna, AK 99669
Phone (907) 420-0836

35249 Kenai Spur Hwy
Ste C
Soldotna, AK 99669
Phone (907) 420-0836

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1770031767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1650",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996111650",
            "telephone_number": "907-953-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W MARYDALE AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697420",
            "telephone_number": "907-262-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDLOW",
        "first_name": "CHELSEA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "PHYO2861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.